President Edgar Lungu has declared HIV testing mandatory or compulsory, meaning that from now on you will be forced to take an HIV test whether you want or not.

As FDD we strongly oppose mandatory HIV testing for a number of reasons: Mandatory HIV testing is unethical as it violates human rights; it violates the privacy and bodily integrity of persons and is actually detrimental to public health as it is counterproductive as many people would shy away from health centres for fear of being forced into testing against their will.

No one, not even a government has the right to force someone to take a test they don't want to. People must take a conscious decision to either take the HIV test or not. In the case of Lewanika vs. Frederick Chiluba, the Supreme Court of Zambia ruled that extracting a blood sample from any person without their consent is an infringement on their constitutional right and must not be tolerated.

Studies the world over have proved that mandatory testing does not result into reduced cases of HIV and AIDS. There is no evidence whatsoever that mandatory testing of HIV results into behavioural change.

The World Health Organisation, to which Zambia is a signatory has defined five key components(5-Cs) that must be respected and adhered to by all HTC services. These components are:

1. Consent

2. Confidentiality

3. Counselling

4. Correct test results

5. Connection/linkage to prevention, care and treatment.

The five Cs, and the key principles they entail, apply to all models of HTC services.

People being tested for HIV must give informed consent to be tested. They must be physically and pychologically prepared to take the test. They must be informed of the process for HTC, the services that will be available depending on the results, and their right to refuse testing.

Mandatory or compulsory (coerced) testing is never appropriate, regardless of where that coercion comes from, government inclusive.

The UNAIDS World AIDS Day Report of 2012 provides evidence that adhering to the principles of voluntary testing and practices for HTC and linking those tested to HIV prevention, treatment, care, and support can enable countries to reduce the incidence of new HIV infections and reduce HIV-related morbidity and mortality. These gains are further enhanced when countries take steps to increase access to: voluntary HTC, including for key at-risk and vulnerable populations; prevention of mother-to-child transmission of HIV (PMTCT); and ARV treatment to all those who need it.

Instead of forcing people to test for HIV against their own will, government should instead focus its energies on addressing the following issues in order to combat the spread of HIV:

1. Ensuring expanded access through an ethical process for conducting HTC, including defining the purpose of the test and the risks and benefits to the person being tested.

2. Assuring linkages between the site where the test is conducted and appropriate treatment, care, prevention, and other services, in an environment that guarantees confidentiality of all medical information.

3. Addressing the implications of a positive test result, including the risk of discrimination and stigma and the importance of early enrolment in HIV treatment, care and follow-up services as needed.

4. Reducing HIV-related stigma and discrimination at all levels, including within health-care settings.

5. Ensuring a supportive legal and policy framework within which the response is scaled up, including safeguarding the human rights of people accessing HTC and other services.

6. Improving the healthcare infrastructure so quality services adhering to these principles can be sustained in the face of increased demand for testing, treatment, and related services and ensures effective monitoring and evaluation is in place.

Issued by Antonio Mwanza, FDD Deputy National Secretary and Party Spokesperson.

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